Archive for the ‘Built Environment and Public Health (Textbook)’ Category

The destruction in New York City reminded me of the role of public health in preparing for and responding to natural disasters. Here is the introduction to the Natural Disasters and Infrastructure Chapter in my book, The Built Environment and Public Health

Though many people would like to think that those of us living in this most modern and wealthy society are immune to the effects of natural disasters, events in the past several decades have continued to highlight the vulnerability of people to natural disasters even in those countries that consider themselves to be the most advanced. In the United States, there have been the repeated disasters caused by hurricanes, most notably Hurricane Andrew in 1992 and Hurricane Katrina in 2005. In addition, portions of the United States are highly vulnerable to earthquakes with the 1989 Loma Prieta earthquake responsible for 63 deaths and billions of dollars in damages including the failure of a freeway in Oakland, California. More subtle, but perhaps just as deadly are extreme weather events which have killed thousands in the United States and Europe in the past 15 years. While these deaths are perhaps not as dramatic as those caused by earthquakes and hurricanes, collectively they are responsible for many more deaths.

But infrastructure is not just a factor in preventing mortality, well-built and well-maintained infrastructure can be central in the promotion of health. Much of this health affirming infrastructure is discussed elsewhere in this book, for example, the role of sidewalks in promoting health is presented in Chapter 4 and the ability of well-designed communities to promote physical activity is addressed in the Chapter 3. But there are other very valuable types of infrastructure and this chapter will include such features as parks and playgrounds and their impact on public health.

A major theme in a discussion of natural disasters, and health is that even though the exact timing of many of these events cannot be predicted, their effects can be anticipated, protective measures adopted, responses planned, and deaths and injuries prevented. There is no inevitability about the deadliness of natural disasters.

Summer 2012 Issue 210 – 9 – Florida Journal of Environmental Health – www.feha.org
FEATURE ARTICLE
“The Built Environment
and Public Health “
by Russell P. Lopez
A book review by
Dorothea M. Volzer, MFA
Written in an easy-to-understand style,
The Built Environment and Public Health by
Russell P. Lopez contains a wealth of
information. The data supplied substantiate
the author’s concern that public health is
definitely affected by the environment that
we have built for ourselves.
Starting with community design, Mr.
Lopez shows the impact on our health. The
growth of suburbs has resulted in sprawl,
loss of farmland, more roads, and more
cars with longer commutes. These issues
in public health were not a concern until
the obesity epidemic. Promoting walking
and bicycling, reducing the need for a car,
and eating better foods can make a big
difference. Better health results from better
environment. Simple things like providing
access to goods and services, parks, and
recreation areas that can be walked to will
help with obesity and overall health. In
addition, car emissions also go down.
Obvious improvements in housing have
helped. Indoor plumbing, better appliances,
and improved building practices are all
helping to keep our environment healthier.
There is still much to be done with our air
quality, both indoor and outdoor. Major
improvements since the 1970s legislation
have significantly helped improve outdoor
air quality. Even so, ozone is still above the
EPA standards in many areas of the United
States. The Built Environment and Public Health
showed the many areas that still require
improvement. Particulates, such as road
dust and industrial emissions, harm lung
function. More homes and condos by
major highways are exposed to a lot of air
pollution. Second-hand smoke continues to
be a problem as well as the indoor air quality
within our schools. While we monitor
water quality, use graywater for irrigation,
and have started some desalinization, this
book points out many areas that need to be
addressed before our built environment will
really improve the public health.
Any program designed to address obesity
must include the food we eat. Mr. Lopez
does not disappoint in this area, and he
includes many relevant ideas. For the
majority of the United States, our food
travels thousands of miles from where it is
grown to our supermarkets. Along the way,
it can be contaminated in numerous ways as
we have experienced or heard about on the
news. Recalls are almost a daily event. The
increase in popularity and number of local
farmer’s markets will result in healthier
food and a healthier public.
Population health has been, and may
always be, related to affluence. Besides
income, race, age, and disabilities can
determine your vulnerability to poor health
in the built environment. Mental health is
also affected by noise levels, lack of parks
and green areas, and population density.
Road rage has increasingly become a
problem in the United States.
This book states that low income and
race increase the risk of poor health
because of their poor built environment.
The environmental justice movement
gives all people an equal right to a clean,
healthy environment. The mid-1980s
brought this idea to the forefront. By 1994,
the National Institute of Environmental
Health Services made the consideration of
environmental justice part of United States
federal decisions.
The last chapter deals with information
and tools available to make better health
through a better environment possible for
all of us. The guidelines contained in The
Built Environment and Public Health by Russell
P. Lopez make it a must-read for all who
work in public health.

The United States has a long history of individuals growing their own food, even in cities. During times of war these “victory gardens” have been promoted as a patriotic way that those on the home front can support the war effort. But even during times of peace, and particularly during economic downturns, urban gardening has been popular. In low-income neighborhoods there is the added benefits that urban gardening can preserve and protect open space that may otherwise be possibly subject to illegal dumping and other illicit activities. There are also numerous advantages for the gardeners that include increased social capital, more physical activity, and better nutrition. Studies of urban gardeners suggest that gardens provide multiple opportunities for interaction and can help the elderly keep from becoming isolated. A major concern with gardening has been pre-existing contamination of urban soils, particularly lead, on land that was formerly used for residential purposes; oils, lead, petroleum products, and solvents on land that was once used for parking; metals and other contaminants if the site was previously used for industry; and of the various unknown contaminants that may be found on any land that was once abandoned. To address these concerns, organizations that own and develop urban gardens in conjunction with local groups often will extensively test the soils and remediate them if they are found to be contaminated.

The community benefits of gardening include the potential for managing vacant and abandoned land, their ability to bring neighbors together and thus promote increased social capital, strengthening of the local food environment, contributions to open space preservation and reductions in the amount of impermeable surfaces in the city, and positive psychological effects on neighbors and communities for having attractive well-maintained open space. These gardens can also be significant locations of physical activity.

A major issue in some communities has been land tenure, or who owns an urban garden site. Many gardens are located in areas that have seen large-scale disinvestment and thus the parcels have been abandoned. If the city has foreclosed on these parcels and transferred title to a local non-profit organization, the long-term ownership of the site can be more certain. But often these gardens are located on parcels whose ownership has not been established or a city may be reluctant to relinquish permanent ownership to a local organization and when values begin to rise because of gentrification or competing demands for the land, the city or other landowner may try to eject the gardeners and use the land for other purposes. This was a major issue in New York City when the city administration decided it wanted to use land that had been gardened for new housing construction. It was only ultimately resolved after long negotiations and the intervention of benefactors who helped fund local groups to purchase the land.

One solution to this problem of ownership and community control is the land trust, a community-based and/or nonprofit organization created specifically to own and manage land for gardening purposes. These organizations, which often need grant support to function, can hold on to the title of the land under gardens. They can provide support to local gardeners, assist gardening groups to administer and manage gardens, serve as an interface between local gardening groups and city administrations, and work to ensure harmonious relationship between gardeners and the neighbors.

There have been objections to gardens. Some neighbors have expressed concerns about the establishment of gardens because they fear that criminals may hide in the gardens, they do not like the way the gardens look, they fear that there may be decreased land values around the gardens, or because of other similar reasons. The solutions to these problems with the neighbors include education, so that neighbors understand the value added by a garden, neighborhood involvement so that problems are not become a conflict between insiders and outsiders, and fencing of gardens so that they look attractive from the street. All these actions may require resources that some gardens may not have.

As noted in Chapter 2, architects, theorists and others including Clarence Perry, Raymond Unwin, Frank Lloyd Wright, and others proposed suburban development forms intended, in part, to promote health. These ideas had been influenced by the urban problems of the late 19th and early 20th centuries. Along with increasing affluence, new technologies, and a number of other factors, these new suburban ideas helped produce a form of the built environment that dominated most of the United States during the second half of the 20th century. For the purposes of this book, we will call it “conventional development” and though there were variations in this form, mostly the result of the legacy of development that predated the triumph of this development pattern or changes in suburbanization that occurred as it progressed through a variety of development waves, it characterizes most of the development in rural, suburban, urban areas in these decades. In general, conventional development consists of single family homes on lots of at least 6,000 square feet, but often on lots of a quarter acre or larger. These houses are set back from the street with a substantial landscaped front yard and a driveway leading to a garage that can accommodate two or more vehicles. Views of the street from most of the house are not possible. Many residential streets are cul-de-sacs or semi closed off so that through traffic is discouraged. These streets open on to collector streets which feed into arterials and then highways. Most housing is distant from any commercial, industrial, or other non-residential uses, though there may be a park or recreational space in the neighborhood. Schools may or may not be present and similarly, sidewalks and other pedestrian amenities are optional.

Commercial uses tend to be either in strip developments or in malls, but in both cases, stores are separated from streets by large areas of parking. These commercial areas sometimes have sidewalks, but these are far from building entries and often along arterials built to promote the travel of high volumes of traffic at high speeds. Walking to or between commercial developments is difficult and rare. Making them even less pedestrian friendly, an important percentage of commercial development is oriented towards highway off ramps rather than residential development. Offices are often in large suburban developments that include a number of discreet buildings, each surrounded by substantial parking lots. These office parks are not accessible by walking or bicycling, either. In center cities, many office and commercial developments are designed on the assumption that suburban users and visitors fear inner city crime and will only visit and use downtown buildings if they are heavily separated from surrounding neighborhoods. Many mid 20th century urban office buildings favor blank facades at street level, entries are tightly monitored, and surface and structured parking are subsidized to make driving easier.

Here is an excerpt from my textbook, The Built Environment and Public Health. The issue is how we fund mass transit in this country. Highways are funded as a block grant, more or less. The issue is how to divide the pot of money and localities don’t have to do much more than spend the cash. In contrast, we make mass transit go through hoops. Keep in mind that the gas tax, both local and national, pays only a fraction of the total cost of our roads. This is not even counting the environmental impacts. Here is what the textbook says:

Transit funding by the federal government uses a different set of procedures than that for highways. Money for highway construction is distributed using a formula that includes population, land area, and other factors. States and localities more or less get the money from the government by right. The only question is how many total dollars have been set aside in the latest highway bill. In contrast, mass transit is funded by a much more cumbersome process. For example, local transportation authorities have to apply to the federal government in a competitive process. Extensive documentation for the application is required and the application process includes an assessment regarding whether revenues are sufficient to maintain and operate the new transportation infrastructure. Funding for mass transit in recent years has been set at no more than 20% of the total federal transportation construction budget, an increase from earlier decades when funding for mass transit from the federal government was essentially zero. Thus transit funds are much more scarce than highway funds and much more difficult to secure. Therefore, local governments have to find alternatives to fund capital and maintenance costs of transit.